Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD

Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN)

doi:10.1016/j.chest.2018.10.044

Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD

Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN)

Medicine

Résultat de recherche: Article › examen par les pairs

80 Citations (Scopus)

Résumé

Background: The effectiveness of influenza vaccination in reducing influenza-related hospitalizations among patients with COPD is not well described, and influenza vaccination uptake remains suboptimal. Methods: Data were analyzed from a national, prospective, multicenter cohort study including patients with COPD, hospitalized with any acute respiratory illness or exacerbation between 2011 and 2015. All patients underwent nasopharyngeal swab screening with polymerase chain reaction (PCR) testing for influenza. The primary outcome was an influenza-related hospitalization. We identified influenza-positive cases and negative control subjects and used multivariable logistic regression with a standard test-negative design to estimate the vaccine effectiveness for preventing influenza-related hospitalizations. Results: Among 4,755 hospitalized patients with COPD, 4,198 (88.3%) patients with known vaccination status were analyzed. The adjusted analysis showed a 38% reduction in influenza-related hospitalizations in vaccinated vs unvaccinated individuals. Influenza-positive patients (n = 1,833 [38.5%]) experienced higher crude mortality (9.7% vs 7.9%; P =.047) and critical illness (17.2% vs 12.1%; P <.001) compared with influenza-negative patients. Risk factors for mortality in influenza-positive patients included age > 75 years (OR, 3.7 [95% CI, 0.4-30.3]), cardiac comorbidity (OR, 2.0 [95% CI, 1.3-3.2]), residence in long-term care (OR, 2.6 [95% CI, 1.5-4.5]), and home oxygen use (OR, 2.9 [95% CI, 1.6-5.1]). Conclusions: Influenza vaccination significantly reduced influenza-related hospitalization among patients with COPD. Initiatives to increase vaccination uptake and early use of antiviral agents among patients with COPD could reduce influenza-related hospitalization and critical illness and improve health-care costs in this vulnerable population. Trial Registry: ClinicalTrials.govNo.:NCT01517191; URL www.clinicaltrials.gov

Langue d'origine	English
Pages (de-à)	69-78
Nombre de pages	10
Journal	Chest
Volume	155
Numéro de publication	1
DOI	https://doi.org/10.1016/j.chest.2018.10.044
Statut de publication	Published - janv. 2019

Note bibliographique

Funding Information:
Financial/nonfinancial disclosures: The authors have reported to CHEST the following: T. H. reports payments from the GlaxoSmithKline (GSK) group of companies, Pfizer, and AbbVie outside the submitted work. M. K. A. reports grant funding from the GSK group of companies, Pfizer, and Sanofi Pasteur. A. C. reports payments from Sanofi outside the submitted work and was previously employed by GSK. G. D. S. was an external consultant at Business & Decision Life Sciences (on behalf of GSK) at the time of the study, is currently employed by the GSK group of companies, and holds shares in the GSK group of companies. M. E. reports payments from the GSK group of companies, the Public Health Agency of Canada, and the Canadian Institutes for Health Research during the conduct of the study. F. H. is employed by the GSK group of companies. S. A. H. reports payments from the GSK group of companies during the conduct of the study and outside the submitted work. B. I. was employed by the GSK group of companies at the time of the study and is now employed by Bayer Inc. J. M. L. reports payments from the GSK group of companies and the Canadian Institutes for Health Research during the conduct of the study and reports payment from the GSK group of companies outside the submitted work. M. L. has received funding honoraria for speaking/advisory roles for Sanofi, Seqirus, Pfizer, and AstraZeneca. J. E. M. reports payments to her institution from the GSK group of companies and Sanofi Pasteur outside of the submitted work. A. McGeer reports payments to her institution from the GSK group of companies for the conduct of this study and payments from Hoffmann–La Roche and Sanofi Pasteur outside the submitted work. J. P. reports payments from the GSK group of companies, Merck, Roche, and Synthetic Biologics outside the submitted work. M. S. reports payments from the GSK group of companies and Pfizer during the conduct of the study. V. S. was employed by GSK Vaccines at the time of the study and is now employed by Novavax Vaccines and holds shares in the GSK group of companies. S. T. reports payments from the Canadian Institutes for Health Research during the conduct of the study. L. V. reports payments from the GSK group of companies during the conduct of the study. S. A. M. reports payments from the GSK group of companies during the conduct of the study and reports payments from Pfizer, Merck, Novartis and Sanofi outside the submitted work. None declared (S. M., L. L., L. Y., A. A., G. B., W. B., K. G., J. J., K. K., J. L., D. M.-C., A. McCarthy., D. R., D. S., and D. W.).

Publisher Copyright:
© 2018 American College of Chest Physicians

ASJC Scopus Subject Areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

ODD de l’ONU

Cette action contribue à la réalisation des objectifs de développement durable suivants

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10.1016/j.chest.2018.10.044

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@article{0e202a0df1704ee8b47dacd305aaac82,

title = "Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD",

abstract = "Background: The effectiveness of influenza vaccination in reducing influenza-related hospitalizations among patients with COPD is not well described, and influenza vaccination uptake remains suboptimal. Methods: Data were analyzed from a national, prospective, multicenter cohort study including patients with COPD, hospitalized with any acute respiratory illness or exacerbation between 2011 and 2015. All patients underwent nasopharyngeal swab screening with polymerase chain reaction (PCR) testing for influenza. The primary outcome was an influenza-related hospitalization. We identified influenza-positive cases and negative control subjects and used multivariable logistic regression with a standard test-negative design to estimate the vaccine effectiveness for preventing influenza-related hospitalizations. Results: Among 4,755 hospitalized patients with COPD, 4,198 (88.3%) patients with known vaccination status were analyzed. The adjusted analysis showed a 38% reduction in influenza-related hospitalizations in vaccinated vs unvaccinated individuals. Influenza-positive patients (n = 1,833 [38.5%]) experienced higher crude mortality (9.7% vs 7.9%; P =.047) and critical illness (17.2% vs 12.1%; P <.001) compared with influenza-negative patients. Risk factors for mortality in influenza-positive patients included age > 75 years (OR, 3.7 [95% CI, 0.4-30.3]), cardiac comorbidity (OR, 2.0 [95% CI, 1.3-3.2]), residence in long-term care (OR, 2.6 [95% CI, 1.5-4.5]), and home oxygen use (OR, 2.9 [95% CI, 1.6-5.1]). Conclusions: Influenza vaccination significantly reduced influenza-related hospitalization among patients with COPD. Initiatives to increase vaccination uptake and early use of antiviral agents among patients with COPD could reduce influenza-related hospitalization and critical illness and improve health-care costs in this vulnerable population. Trial Registry: ClinicalTrials.govNo.:NCT01517191; URL www.clinicaltrials.gov",

author = "{Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN)} and Sunita Mulpuru and Li Li and Lingyun Ye and Todd Hatchette and Andrew, {Melissa K.} and Ardith Ambrose and Guy Boivin and William Bowie and Ayman Chit and {Dos Santos}, Gael and May ElSherif and Karen Green and Francois Haguinet and Halperin, {Scott A.} and Barbara Ibarguchi and Jennie Johnstone and Kevin Katz and Langley, {Joanne M.} and Jason LeBlanc and Mark Loeb and Donna MacKinnon-Cameron and Anne McCarthy and McElhaney, {Janet E.} and Allison McGeer and Jeff Powis and David Richardson and Makeda Semret and Vivek Shinde and Daniel Smyth and Sylvie Trottier and Louis Valiquette and Duncan Webster and McNeil, {Shelly A.} and Philippe Lagace-Wiens and Bruce Light and Andre Poirier and Stephanie Smith and Gregory Taylor",

note = "Funding Information: Financial/nonfinancial disclosures: The authors have reported to CHEST the following: T. H. reports payments from the GlaxoSmithKline (GSK) group of companies, Pfizer, and AbbVie outside the submitted work. M. K. A. reports grant funding from the GSK group of companies, Pfizer, and Sanofi Pasteur. A. C. reports payments from Sanofi outside the submitted work and was previously employed by GSK. G. D. S. was an external consultant at Business & Decision Life Sciences (on behalf of GSK) at the time of the study, is currently employed by the GSK group of companies, and holds shares in the GSK group of companies. M. E. reports payments from the GSK group of companies, the Public Health Agency of Canada, and the Canadian Institutes for Health Research during the conduct of the study. F. H. is employed by the GSK group of companies. S. A. H. reports payments from the GSK group of companies during the conduct of the study and outside the submitted work. B. I. was employed by the GSK group of companies at the time of the study and is now employed by Bayer Inc. J. M. L. reports payments from the GSK group of companies and the Canadian Institutes for Health Research during the conduct of the study and reports payment from the GSK group of companies outside the submitted work. M. L. has received funding honoraria for speaking/advisory roles for Sanofi, Seqirus, Pfizer, and AstraZeneca. J. E. M. reports payments to her institution from the GSK group of companies and Sanofi Pasteur outside of the submitted work. A. McGeer reports payments to her institution from the GSK group of companies for the conduct of this study and payments from Hoffmann–La Roche and Sanofi Pasteur outside the submitted work. J. P. reports payments from the GSK group of companies, Merck, Roche, and Synthetic Biologics outside the submitted work. M. S. reports payments from the GSK group of companies and Pfizer during the conduct of the study. V. S. was employed by GSK Vaccines at the time of the study and is now employed by Novavax Vaccines and holds shares in the GSK group of companies. S. T. reports payments from the Canadian Institutes for Health Research during the conduct of the study. L. V. reports payments from the GSK group of companies during the conduct of the study. S. A. M. reports payments from the GSK group of companies during the conduct of the study and reports payments from Pfizer, Merck, Novartis and Sanofi outside the submitted work. None declared (S. M., L. L., L. Y., A. A., G. B., W. B., K. G., J. J., K. K., J. L., D. M.-C., A. McCarthy., D. R., D. S., and D. W.). Publisher Copyright: {\textcopyright} 2018 American College of Chest Physicians",

year = "2019",

month = jan,

doi = "10.1016/j.chest.2018.10.044",

language = "English",

volume = "155",

pages = "69--78",

journal = "Chest",

issn = "0012-3692",

publisher = "American College of Chest Physicians",

number = "1",

}

TY - JOUR

T1 - Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD

AU - Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN)

AU - Mulpuru, Sunita

AU - Li, Li

AU - Ye, Lingyun

AU - Hatchette, Todd

AU - Andrew, Melissa K.

AU - Ambrose, Ardith

AU - Boivin, Guy

AU - Bowie, William

AU - Chit, Ayman

AU - Dos Santos, Gael

AU - ElSherif, May

AU - Green, Karen

AU - Haguinet, Francois

AU - Halperin, Scott A.

AU - Ibarguchi, Barbara

AU - Johnstone, Jennie

AU - Katz, Kevin

AU - Langley, Joanne M.

AU - LeBlanc, Jason

AU - Loeb, Mark

AU - MacKinnon-Cameron, Donna

AU - McCarthy, Anne

AU - McElhaney, Janet E.

AU - McGeer, Allison

AU - Powis, Jeff

AU - Richardson, David

AU - Semret, Makeda

AU - Shinde, Vivek

AU - Smyth, Daniel

AU - Trottier, Sylvie

AU - Valiquette, Louis

AU - Webster, Duncan

AU - McNeil, Shelly A.

AU - Lagace-Wiens, Philippe

AU - Light, Bruce

AU - Poirier, Andre

AU - Smith, Stephanie

AU - Taylor, Gregory

N1 - Funding Information: Financial/nonfinancial disclosures: The authors have reported to CHEST the following: T. H. reports payments from the GlaxoSmithKline (GSK) group of companies, Pfizer, and AbbVie outside the submitted work. M. K. A. reports grant funding from the GSK group of companies, Pfizer, and Sanofi Pasteur. A. C. reports payments from Sanofi outside the submitted work and was previously employed by GSK. G. D. S. was an external consultant at Business & Decision Life Sciences (on behalf of GSK) at the time of the study, is currently employed by the GSK group of companies, and holds shares in the GSK group of companies. M. E. reports payments from the GSK group of companies, the Public Health Agency of Canada, and the Canadian Institutes for Health Research during the conduct of the study. F. H. is employed by the GSK group of companies. S. A. H. reports payments from the GSK group of companies during the conduct of the study and outside the submitted work. B. I. was employed by the GSK group of companies at the time of the study and is now employed by Bayer Inc. J. M. L. reports payments from the GSK group of companies and the Canadian Institutes for Health Research during the conduct of the study and reports payment from the GSK group of companies outside the submitted work. M. L. has received funding honoraria for speaking/advisory roles for Sanofi, Seqirus, Pfizer, and AstraZeneca. J. E. M. reports payments to her institution from the GSK group of companies and Sanofi Pasteur outside of the submitted work. A. McGeer reports payments to her institution from the GSK group of companies for the conduct of this study and payments from Hoffmann–La Roche and Sanofi Pasteur outside the submitted work. J. P. reports payments from the GSK group of companies, Merck, Roche, and Synthetic Biologics outside the submitted work. M. S. reports payments from the GSK group of companies and Pfizer during the conduct of the study. V. S. was employed by GSK Vaccines at the time of the study and is now employed by Novavax Vaccines and holds shares in the GSK group of companies. S. T. reports payments from the Canadian Institutes for Health Research during the conduct of the study. L. V. reports payments from the GSK group of companies during the conduct of the study. S. A. M. reports payments from the GSK group of companies during the conduct of the study and reports payments from Pfizer, Merck, Novartis and Sanofi outside the submitted work. None declared (S. M., L. L., L. Y., A. A., G. B., W. B., K. G., J. J., K. K., J. L., D. M.-C., A. McCarthy., D. R., D. S., and D. W.). Publisher Copyright: © 2018 American College of Chest Physicians

PY - 2019/1

Y1 - 2019/1

N2 - Background: The effectiveness of influenza vaccination in reducing influenza-related hospitalizations among patients with COPD is not well described, and influenza vaccination uptake remains suboptimal. Methods: Data were analyzed from a national, prospective, multicenter cohort study including patients with COPD, hospitalized with any acute respiratory illness or exacerbation between 2011 and 2015. All patients underwent nasopharyngeal swab screening with polymerase chain reaction (PCR) testing for influenza. The primary outcome was an influenza-related hospitalization. We identified influenza-positive cases and negative control subjects and used multivariable logistic regression with a standard test-negative design to estimate the vaccine effectiveness for preventing influenza-related hospitalizations. Results: Among 4,755 hospitalized patients with COPD, 4,198 (88.3%) patients with known vaccination status were analyzed. The adjusted analysis showed a 38% reduction in influenza-related hospitalizations in vaccinated vs unvaccinated individuals. Influenza-positive patients (n = 1,833 [38.5%]) experienced higher crude mortality (9.7% vs 7.9%; P =.047) and critical illness (17.2% vs 12.1%; P <.001) compared with influenza-negative patients. Risk factors for mortality in influenza-positive patients included age > 75 years (OR, 3.7 [95% CI, 0.4-30.3]), cardiac comorbidity (OR, 2.0 [95% CI, 1.3-3.2]), residence in long-term care (OR, 2.6 [95% CI, 1.5-4.5]), and home oxygen use (OR, 2.9 [95% CI, 1.6-5.1]). Conclusions: Influenza vaccination significantly reduced influenza-related hospitalization among patients with COPD. Initiatives to increase vaccination uptake and early use of antiviral agents among patients with COPD could reduce influenza-related hospitalization and critical illness and improve health-care costs in this vulnerable population. Trial Registry: ClinicalTrials.govNo.:NCT01517191; URL www.clinicaltrials.gov

AB - Background: The effectiveness of influenza vaccination in reducing influenza-related hospitalizations among patients with COPD is not well described, and influenza vaccination uptake remains suboptimal. Methods: Data were analyzed from a national, prospective, multicenter cohort study including patients with COPD, hospitalized with any acute respiratory illness or exacerbation between 2011 and 2015. All patients underwent nasopharyngeal swab screening with polymerase chain reaction (PCR) testing for influenza. The primary outcome was an influenza-related hospitalization. We identified influenza-positive cases and negative control subjects and used multivariable logistic regression with a standard test-negative design to estimate the vaccine effectiveness for preventing influenza-related hospitalizations. Results: Among 4,755 hospitalized patients with COPD, 4,198 (88.3%) patients with known vaccination status were analyzed. The adjusted analysis showed a 38% reduction in influenza-related hospitalizations in vaccinated vs unvaccinated individuals. Influenza-positive patients (n = 1,833 [38.5%]) experienced higher crude mortality (9.7% vs 7.9%; P =.047) and critical illness (17.2% vs 12.1%; P <.001) compared with influenza-negative patients. Risk factors for mortality in influenza-positive patients included age > 75 years (OR, 3.7 [95% CI, 0.4-30.3]), cardiac comorbidity (OR, 2.0 [95% CI, 1.3-3.2]), residence in long-term care (OR, 2.6 [95% CI, 1.5-4.5]), and home oxygen use (OR, 2.9 [95% CI, 1.6-5.1]). Conclusions: Influenza vaccination significantly reduced influenza-related hospitalization among patients with COPD. Initiatives to increase vaccination uptake and early use of antiviral agents among patients with COPD could reduce influenza-related hospitalization and critical illness and improve health-care costs in this vulnerable population. Trial Registry: ClinicalTrials.govNo.:NCT01517191; URL www.clinicaltrials.gov

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Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD

Résumé

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ASJC Scopus Subject Areas

ODD de l’ONU

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